Journal of the National Cancer Institute
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J. Natl. Cancer Inst. · Nov 2007
Multicenter StudyPredicting risk of breast cancer in postmenopausal women by hormone receptor status.
Strategies for estrogen receptor (ER)-positive breast cancer risk reduction in postmenopausal women require screening of large populations to identify those with potential benefit. We evaluated and attempted to improve the performance of the Breast Cancer Risk Assessment Tool (i.e., the Gail model) for estimating invasive breast cancer risk by receptor status in postmenopausal women. ⋯ In postmenopausal women, the Gail model identified populations at increased risk for ER-positive but not ER-negative breast cancers. A model with fewer variables appears to provide a simpler approach for screening for breast cancer risk.
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J. Natl. Cancer Inst. · Nov 2007
CommentStatistical methods for analyzing sequentially randomized trials.
In this issue of the Journal, Thall et al. present the results of a clinical trial that makes use of sequential randomization, a novel trial design that allows the investigator to study adaptive treatment strategies. Our aim is to complement this groundbreaking work by reviewing the current state of the art of statistical methods available for such analyses. Using the data collected by Thall et al. as an example, we focus on two different approaches for estimating the success rates of different adaptive treatment strategies of interest. By emphasizing the intuitive appeal and straightforward implementation of these methods and illustrating the striking findings to which these methods can lead, we hope to convince the reader that this novel trial design provides a rich source of information that is made readily accessible through current analytical approaches.